The Use of Medication in The Treatment of Opioid Addiction 

What is a huge epidemic running rampant in our world today? For many, the answer would not be addiction. Epidemics are battles against viruses, flus, and other common ailments that haunt our daily lives. Opioid addiction is the physical and mental state of dependence on opioid. The addiction crisis has risen to unprecedented levels. An article describing patients’ preference of medication in therapy said that “In 2012, 2. 1 million people in the U. S. met criteria for past-year abuse/dependence of prescription pain relievers, and half a million people met criteria for heroin use disorders. ” (Uebelacker) Something has to be done to combat this addiction disease that is sweeping across our nation. While there are a number of drug rehabilitation centers across the U. S., the key to the success in the centers lies in their use of medication assisted treatment. Thesis statement: Although medication assisted treatment is viewed by some as counter-productive in the sense that it only replaces one addiction with another, the use of medications such as Buprenorphine and Methadone help to reduce withdrawal symptoms, boost retention of the therapies being provided, and decrease the number of fatal overdoses. With so many suffering, there is an extreme need to cultivate viable options to end addiction. While therapeutic options are available, these do not fully encapsulate a successful strategy for those looking to end their opioid use. This need for better options lead to the eventual creation of different medication that are meant to be used in addition to normal drug rehabilitation therapies. Insert facts about each of the medications and their uses.

The first drug that will be discussed is Methadone. Methadone is an opioid agonist which means it changes the way the brain and the nervous system interact with opioid receptors. Also, it changes the way the body reacts to pain allowing users to detox from opioids without harmful withdrawal effects. One of the biggest pieces of information to consider about Methadone is that it “blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone”(Walsh). This is important to consider when arguing that Methadone is not a harmful drug that allows users a different “high” in replacement of their choice opioid. In addition to Methadone, this paper will also discuss the uses of Buprenorphine which is another common medication used to treat patients with opioid addiction. Buprenorphine is an opioid partial agonist which means that it still produces effects of euphoria and respiratory depression but in much weaker states. This medication essential creates a “ceiling” for the effects a user can feel which allows patients to not require as much opioids and eventually ween off them all together. Along with these medications, a normal drug rehabilitation process could include in-patient and out-patient programs that include extensive therapy built around mental health and processes for staying sober. Buprenorphine and methadone are both effective medications that can be used in addition to normal therapies to reduce drug use and help those struggling with opioid addiction as well as increasing the likelihood patients will continue therapy. As previously stated, Buprenorphine and Methadone work to relieve the withdrawal symptoms of those detoxing from opioids. This may not seem very useful to those who are not currently living with addiction but the fact that addicts do not have to face horrible withdrawal symptoms can greatly increase the chances that patients will be more receptive to different therapies. Medication assisted treatments will “increase patients' retention in treatment, and they all improve social functioning as well as reduce the risks of infectious-disease transmission and of engagement in criminal activities. ” (Volkow). Even though these medications may not cure addiction, they have a meaningful impact. While discussing the positive aspects of these drugs, the ability to curb future use is brought to mind. Relapse is a very serious issue facing those who have triumphed and gotten clean; in fact, one of the reasons some addicts relapse is due to the intense cravings and withdrawal they experience. Relapsing is just as dangerous, if not more so, for those who have escaped the use of opioids. During a drug relapse, many drug users will fall back to using the same amount of opioids as they did when they quit but their bodies are not used taking in this much of a substance which can lead to a fatal overdose.

The Article of New England Medicine has shown that “maintenance MAT has been shown to prevent relapse and death but is strongly discouraged by lifetime limits” (Volkow). This is a huge step forward in the battle to end addiction. Lives will be saved from the use of these medication addiction therapies. While many believe Buprenorphine and Methadone have numerous benefits, a select few believe that these medications are a just a means of replacing one addiction with another. Since Buprenorphine and Methadone affect the brain in the same way as most opioids, it is believed that many of those who utilize these medications are not truly getting clean. In and NPR article discussing addiction, a former addict describes his use of Buprenorphine as “he would often exceed the dosage, buying pills from other patients so he wouldn't run out. He stopped using other narcotics and, overall, he felt more functional. Still, after three years of seeing the doctor, he never felt like he'd achieved full recovery. ” (Hsu) There is a common misconception that a majority of those who switch to these opioid based medications will never fully be sober. This idea creates hesitation regarding the use of these medications to fully allow someone to become sober. A majority of this discomfort stems from being unknowledgeable about the subject. Donald Avoy, M. D. , in his book Professional Prospective on Addiction Medication, write “Professionals in the criminal justice system have viewed it with suspicion for forty years. It is poorly understood by most medical professionals. It is looked on with despair by the families of persons taking it. The general public is only vaguely acquainted with it. ”(Stanford) It is clear that this lack of knowledge has created a stigma surrounding both of these medications. These ideas can be harmful to the many people who could benefit from these kinds of treatments. Stigmatizing Methadone and Buprenorphine has limited the availability of these medications to the public.

The patients in need have been so affected that “only a fraction of the more than 4 million people believed to abuse prescription painkillers or heroin in the U. S. are being given what's called medication-assisted treatment. ” (Hsu) By reversing the stigma, we can help those truly in need by providing lifesaving therapies. These medications are not intended to provide users with the desired feeling of euphoria and well-being. These medications are used to allow drug addicts to feel “normal” which allows them to be more present and receptive to the therapies that they are attending. If a person was going through extreme symptoms of detoxification then they would not be able to receive the best treatment possible. When these symptoms are lessened or taken away completely it helps drive the message of sobriety. In addition to the previous statement, these medications help to eradicate some of the initial fear of finally taking that first step to overcome drug use. These medications are not switching addictions. While there is a chance for dependence upon these medication, there are methods in place to ensure they are not used in that fashion. Most of rehabilitation centers take care in introducing patients to these medications and slowly tapering them off over time. In doing so, the patients do not feel a sense of addiction to the medications they are prescribed. Research suggests that Buprenorphine and Methadone are not addictive substances but rather proper medicines that further the treatment for patients in rehabilitation situations.

A number of the population views medication assisted treatment as a destructive force in the fight towards sobriety, but these medications provide much needed support by allowing those struggling with addiction to fight off terrible withdrawal symptoms, retain the information their learning in rehabilitation, and decrease the chances of a fatal overdose. Buprenorphine and Methadone are two of the most popular medications provided to those in drug rehabilitation therapy. Buprenorphine, a partial opioid agonist, providers user with a sense of well-being but creates a “ceiling” for their opioid intake which allows for a stable tapering system to drive sobriety in a non-harmful manner. In addition to Buprenorphine, another drug is Methadone, an opioid agonist, that blocks the euphoric effects of illicit opioid drugs and removes uncomfortable withdrawal symptoms. If patients are given these medications, they will be able to more fully comprehend the rehabilitation courses they are attending. Furthermore, the ability to stave off withdrawal symptoms decreases the likely hood that patients will succumb to a possibly fatal overdose. Even with all the positive aspect, there is still a part of the population that believes these medications hold no value and decrease the total sobriety of struggling addicts. However, the use of medication assisted therapy has been scientifically proven that, in a controlled environment where doses can be tapered, these medications further the process of recovery and lead to a better overall standard of living. It is the duty of our nation to provide the best support possible for those struggling with addiction. Opioid addiction has become an epidemic claiming lives of millions of Americans. If these medications can help end that, are they not a valuable option to institute throughout the country?