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Why We Need Medication-Assisted Addiction Treatment

A pile of pills

A recent post in the Psychology Today blog, Demystifying Addiction, stresses that the current bias and stigma that surround evidence-based addiction treatment using medications can lead to unnecessary deaths. In some cases, abstinence-based treatment for opioid addiction may be even riskier than no treatment at all.

The Power of Medication-Assisted Treatment (MAT)

The author of the post, Ian McLoone, MPS, LPCC, LADC, shares:

As someone who has spent more than a decade helping people overcome addiction, I’ve witnessed firsthand the impact of stigma on accessing life-saving medications. It’s disheartening to encounter program after program that refuses to consider agonist maintenance treatment — using medications like buprenorphine (Suboxone) or methadone for as long as necessary to help patients achieve their goals.

According to McLoone, the evidence is clear that open-ended treatments work, while short-term detoxes often lead to relapse rates above 90%. Also, methadone and buprenorphine are classified as “essential medicines” by the World Health Organization, and major medical organizations, including the American Medical Association, support wider access to these treatments.

Barriers to MAT: Stigma and Misinformation

And yet, despite these benefits, many programs refuse to prescribe MAT due to stigma rooted in outdated ideas that taking medication means someone isn’t “truly in recovery.” This attitude prevents countless patients from accessing life-saving treatment options.

McLoone disputes this notion by citing a recent study, published in Drug and Alcohol Dependence, that found that methadone and buprenorphine reduced mortality rates by 62% and 66%, respectively, compared to no treatment. He writes:

These findings challenge the misconception that medications don’t work, are simply replacing one addiction with another, or that people using medications are somehow not “really” in recovery. Instead, they underscore their potential as life-saving interventions. Remember: Dead people can’t recover.

Why MAT?

MAT provides a number of benefits to those struggling with opioid addiction, including:

  • Helping manage withdrawal symptoms and cravings
  • Lowering the risk of relapse and overdose
  • More readily sustaining employment and housing
  • Reducing death rates and improving outcomes for those with opioid use disorder

What Can Be Done?

McLoone’s call to action includes increasing access to MAT by expanding insurance coverage; combating the stigma surrounding MAT through education and open discussion in communities, healthcare settings, and policy forums; and continuing researching options.

Some lawmakers are realizing that MAT could be one of the options to effectively fight the ongoing opioid crisis. STAT just reported that two Democratic lawmakers, Sen. Martin Heinrich and Rep. Paul Tonko, introduced the “BUPE Act,” which aims to ease Drug Enforcement Administration (DEA) regulations on buprenorphine (also known by the brand name Suboxone), a medication used to treat opioid addiction. 

Buprenorphine, despite reducing the risk of opioid death by 38%, faces strict DEA scrutiny because it is an opioid itself. The proposed legislation seeks to remove buprenorphine from the DEA’s Suspicious Order Reporting System (SORS), which was originally designed to combat the oversupply of addictive painkillers but is now seen as a barrier to accessing the medication. 

Addiction Reporter Lev Facher writes: 

Though the Biden administration has made access to buprenorphine a cornerstone of its opioid crisis response, patients seeking the medication still report that it is prohibitively difficult to access, in large part because few doctors prescribe it and barely half of retail pharmacies stock it.

The legislation has broad support from major medical organizations and adds pressure on the DEA. Facher writes:

Heinrich and Tonko’s legislation adds another layer of pressure for the agency, which is already facing a barrage of criticism from lawmakers and addiction treatment groups, pushback from the Department of Health and Human Services, and multiple pieces of legislation that would effectively undercut its attempt to restrict the prescribing of buprenorphine via telehealth.

The Bottom Line

The opioid crisis is challenging, but not impossible to overcome. Progress is already being made. By embracing evidence-based solutions like MAT and fighting stigma, we can give people the opportunity to rebuild their lives. Medications will be central to this battle. We must use every tool at our disposal.

Written by Tatyana Meshcheryakova. First published October 7, 2024.

Sources:

“Why Are Some Still Opposed to Life-Saving Addiction Treatment?,” Psychology Today, September 30, 2024.

“Receipt of opioid use disorder treatments prior to fatal overdoses and comparison to no treatment in Connecticut, 2016–17,” Drug and Alcohol Dependence, January 2024.

“To aid addiction treatment, lawmakers tell DEA to back off buprenorphine enforcement,” STAT, October 3, 2024.

Image Copyright: Myriam Zilles/Unsplash.

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