Medication-assisted treatment is America’s primary offering for those who are addicted. But implicit in the word “treatment” is recovery from an illness or other condition—as in “not suffering from that condition any longer.” Is medication-assisted treatment really a recovery-oriented therapy? Or is its primary role preventing a person from relapse and overdose?
Vital First Step: Keep a Person Alive
Preventing overdoses is definitely a vital task. If an individual fatally overdoses, they will never have the chance to recover their sobriety.
MAT can therefore have an important place in recovery plans. The use of MAT drugs like Suboxone can aid a person as they phase out of the use of illicit opioids. A limited term of MAT can relieve a person of the life-threatening danger of opioid use along with attendant health, life and legal risks.
Some medical practitioners use MAT as a bridge to a fully drug-free life, tapering their patients off MAT drugs gradually as they progress in their rehabilitation. When they taper fully off MAT, the patient is at last not reliant on any substance and needs no more MAT drugs.
MAT can also be essential for a person who is desperate to enter a rehab program but runs into the barrier of a waiting list. They’re ready to go now but there’s no place to go. MAT can bridge this gap, enabling them to begin living that more orderly life immediately. Then, as soon as there is an opening in the rehab program they have in their sights, they can transition to full recovery.
How Else is MAT Utilized?
Not everyone has the opinion that MAT’s best use is as a life-saver and bridge to full sobriety. Some authorities place no limit on the length of time it should be administered.
For example, the Food and Drug Administration notes: Due to the chronic nature of OUD [opioid use disorder], the need for continuing MAT should be re‐evaluated periodically. There is no maximum recommended duration of maintenance treatment, and for some patients, treatment may continue indefinitely.
If it is necessary to administer MAT indefinitely, what does this say about the effectiveness of the rehabilitation programs being offered to those in treatment?
NIDA Statement on Rehabilitation
The National Institute on Drug Abuse states: Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment. Behavioral therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships. Also, participation in group therapy and other peer support programs during and following treatment can help maintain abstinence.
If these behavioral therapies are effective care for those who are addicted to opioids, then why should MAT be needed “indefinitely”? It may be important to ask this question and seek the answer.
The definition of recovery one uses is an important factor when developing one’s own answer to this question. A typical definition of recovery is this: Returning to normal health, strength or state of mind.
Applied exactly to addiction, this definition of recovery makes it clear that the ideal goal is freedom from drug use and freedom from the need for further treatment. If we are not achieving this outcome, perhaps we should take a harder look at the effectiveness of current methods used to remedy addiction. If the goal of full recovery can be achieved, then it should be achieved, as it the greatest service we could provide to a person who is addicted.