Monday 23 April 2018

Medication-Assisted Treatment Needs Community Support

Communities like Portsmouth, Ohio, regularly make national news for waves of overdoses. On any given day, nearly 100 people across the country die due to opioid overdose. The problem always feels like an uphill battle, and often a losing one for social workers and drug counselors who hope to get clients on the path to sobriety.

Evidence shows that one method, medication assisted treatment (MAT), works; however, for MAT to be truly effective, it takes an entire community.

What Is Medication Assisted Treatment?

Medication assisted treatment is an evidence-based recovery process that combines traditional therapies and detox programs with the use of medication. Medication helps patients manage cravings and provides relief from detoxification symptoms. MAT is useful for people who are addicted to opioids or alcohol.

These are some of the most common medications used to treat in MAT.

  • Buprenorphine: A partial opioid agonist, buprenorphine is used for the treatment of patients who are addicted to prescription painkillers. This medication is the first opioid treatment not required to be administered in a clinic.
  • Probuphine: Approved by the FDA in 2016, the probuphine implant requires four rods to be inserted into the upper arm. The rods provide a continuous dose of buprenorphine for six months to alleviate cravings and withdrawal symptoms.
  • Methadone: Methadone is known as a full opioid agonist, which means that it provides many of the same effects of other opioids. The effects are usually milder and do not impact the patient’s ability to function as much, though.
  • Naloxone: An opioid antagonist, naloxone can reverse or prevent life-threatening overdoses by blocking opioid activity at receptor sites. Police officers and medical workers typically carry these injections and administer as necessary. Sometimes, users also carry them in case of an emergency.
  • Naltrexone: Available as an injectable or in pill form, naltrexone is available as a monthly or daily dose and lacks the potential for abuse.
  • Acamprosate: Sometimes referred to as Campral, acamprosate is used to prevent relapse in alcoholics by lessening the post-acute withdrawal symptoms that often lead to relapse.

Along with medication, patients in an MAT program are required to participate in therapy or counseling.

Healthcare Providers and Community Members Can Erase Stigma

Even though MAT has proven to be an effective form of treatment, there’s still a stigma associated with it, as many believe that it’s about replacing one drug with another. What can be done so that members of behavioral healthcare can recommend this treatment?

Change in Mindset

Addiction is complex. It is a brain disease. Simply viewing addiction as a disease rather than a moral or criminal problem can help make addiction treatment programs, including MAT, more accessible. Despite inclusion in the Diagnostic and Statistical Manual (DSM) and research that states addiction is a disease, many community members and medical professionals do not view addiction in this way. If behavioral healthcare professionals don’t understand addiction as a disease, MAT will continue to be underutilized.

Education

Addiction professionals have a responsibility to educate others on MAT and its effectiveness. There are still misconceptions about what the treatment actually entails.

Social workers, counselors, and others must understand MAT and the evidence that supports this type of program. This also means that healthcare organizations need to mandate ongoing education for staff. Education enables counselors to make appropriate recommendations as to when individuals need abstinence-based treatment or MAT. Both types of treatment can be effective, but which is appropriate for the patients they are treating?

Law enforcement officials should also receive education and training on MAT. This includes promoting MAT as a treatment method for incarcerated addicts. A lack of MAT in prisons means many addicts end up relapsing, and even dying of an overdose because they didn’t receive proper treatment.

Access to Naloxone

Reducing stigma associated with MAT means that access to medication should go beyond the treatment setting. First responders should be trained to carry and administer naloxone. As mentioned earlier in this article, it can be a life-saving step in reducing overdose fatalities. Many states already passed legislation to allow access to naloxone. Healthcare professionals can share research and evidence with community officials to allow access to naloxone or increase supply in cities that already have it.

A holistic solution that involves the whole community is necessary to combat the opioid epidemic, reduce fatalities, and direct people to the appropriate treatment option, whether it’s MAT or not. Community officials and healthcare providers should also look to treatment centers as resources. What can they learn from the individuals who are working with these patients? In order to make MAT effective, it takes community involvement before, during, and after treatment.



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