Opioid use disorders are incredibly difficult to overcome. Even people who achieve sobriety will relapse later, and the threat of relapse is always a significant concern for people in recovery. According to the National Institute on Drug Abuse and Addiction (NIDA), addiction relapse rates are similar to the relapse rates for other chronic diseases like hypertension and asthma, with as many as 60 percent of people returning to some form of drug abuse.
When you enter treatment, it’s important for your treatment center to recognize the possibility of relapse and prepare you to deal with that threat. A good portion of the treatment process is designed to help you learn relapse prevention strategies, preparing you for cravings and compulsions to use during your recovery.
However, relapse still happens. Some people go through chronic relapse, which is when you relapse multiple times after several attempts at sobriety. Still, there are treatment options specifically for people who deal with chronic relapse, and even someone who has achieved recovery and relapsed several times can make it to long-lasting recovery.
One option for someone who has relapsed several times or that has attempted treatment but failed to make it through, is medication-assisted treatment or MAT. MAT involves the use of medications that stave of drug cravings and withdrawal while you go through treatment. This method takes longer, but it can help remove clients from active addiction and a lifestyle of illicit drug use. While on the medication, clients can start psychotherapy and other aspects of addiction treatment.
The process has been controversial because it uses opioids to fight opioid addiction, but its effectiveness is supported by research and organizations like NIDA and the Substance Abuse and Mental Health Services Administration (SAMHSA). Not all MAT medications are equally effective, and some have risen above the rest.
Learn more about MAT and the medications that are used that safe and effective.
Medication-assisted treatment is the use of certain opioid medications to stop people who are addicted to opioids from experiencing uncomfortable withdrawal symptoms or cravings. Medications usually have a low risk for causing intoxication or euphoric effects, but they do bind to opioid receptors in the brain, which help curb withdrawal. Some medications can be abused to achieve a high, but they are prescribed in highly regulated doses.
These medications do not cure addiction. People who use them will be dependent on the new drug until they are eventually weaned off over a period of about a year. So why stave off withdrawal for a later time? Why not just get it over with and then start treatment?
If you’ve been through opioid withdrawal, you know that it’s an extremely unpleasant experience. Even though it’s not typically life-threatening, it’s like one of the worst cases of the flu you’ll ever experience, with symptoms like nausea, vomiting, sweating, diarrhea, and body aches. Someone who’s just coming out of active addiction will also have powerful drug cravings and a nearly irresistible compulsion to use. Cravings and withdrawal symptoms together can make it difficult to make it through detox and treatment.
MAT is designed to remove the distraction of withdrawal and cravings until after you’ve addressed some of the deeper issues contributing to your substance use disorder. Once you’ve gone through treatment, addressed underlying issues, and separate yourself from a lifestyle of active addiction, it may be easier to make it to lasting drug freedom. After about a year, you will be slowly weaned off the medication.
The opioid epidemic is a serious problem in the United States, and researchers have explored and continue to explore a variety of medicinal options. Several drugs are used to treat heroin addiction and the consequences that come with it. Many of these medications have been controversial, but they’ve also saved lives. Not every medication used to treat people who have heroin addiction are for treating opioid dependence.
Narcan (the brand name for naloxone) is a commonly used medication that has been vital to fighting the opioid epidemic around the country. Naloxone doesn’t stop withdrawal symptoms; it actually causes them, but that’s not its primary function. Police, paramedics, other first responders, and even the friends and family of addicted people use Narcan to stop opioid overdoses and essentially bring people back from the brink.
During an opioid overdose, the affected person will have taken a high enough dose of heroin or other opioids to slow down their nervous system to a dangerous degree. The strength of illicit heroin is unpredictable, and it can be difficult to determine a proper dose. If your dealer gets a batch from a new supplier that’s less adulterated, you may take a hit that’s way more powerful than you thought. Plus, the powerful synthetic drug, fentanyl has been making its way into supplies of street heroin, causing a spike in overdose deaths. However, Narcan is an opioid antagonist, which means it binds to opioid receptors and does not activate them. It can kick heroin and other opioids that are causing an overdose off its receptor, reversing the overdose.
Methadone was one of the first medications used to replace heroin addiction with a less harmful opioid. Through a harm reduction process called methadone maintenance, people take a prescribed dose of the opioid to satiate cravings and help avoid withdrawal. Taking a prescribed dose can help you avoid withdrawal without causing intoxication. However, methadone has its drawbacks. In heavy doses, methadone can be abused for a euphoric high. Plus, breaking a dependency on methadone is, in many ways, more difficult than other opioids. Methadone withdrawal is said to be more intense than even heroin withdrawal.
Naltrexone is a medication used to treat both alcohol and opioid addiction. However, it works in a way that’s fairly unique. It doesn’t stop withdrawal or treat overdose; it blocks the euphoric and sedative effects of opioids. If someone on naltrexone were to relapse, the opioid they use would have little to no effects. However, a drawback to naltrexone is that it requires med compliance to work. If someone is going to relapse, they may just as likely stop taking their medication.
One of the best options in medication-assisted treatment is another opioid that can be used to stop withdrawal symptoms and curb cravings. A medication called buprenorphine was first approved in 2002, and it can be used in long-term MAT. It comes in a pill or in sublingual tablets.
Buprenorphine, combined with counseling and behavioral therapies, has shown to be an effective treatment option for heroin addiction. Methadone can be dispensed only in highly structured and regulated clinical settings, but buprenorphine is approved to be prescribed and dispensed by doctors in everyday offices, which increases access to addiction treatment.
People who have not become opioid-dependent may be able to misuse buprenorphine for an opioid high. However, another medication is used to mitigate that risk.
Suboxone is a combination of buprenorphine and naloxone, the drug that blocks opioid overdose. It’s difficult for someone with opioid dependence to achieve a high using buprenorphine because there is a ceiling to its analgesic effects. After a certain amount, the high won’t get any more intense. Someone who’s built a tolerance won’t be able to take enough to get high unless they take it intravenously. And that’s where the naloxone comes in. The drug is prescribed sublingually, and naloxone can’t be absorbed in the mouth very easily.
So, if taken as prescribed, the buprenorphine will prevent withdrawal and cravings while the naloxone is largely inert. If you take the drug intravenously, the naloxone will go to work, kicking any opioid agonists off your receptors and cause immediate withdrawal. That’s pretty clever chemistry.
If you or someone you love is struggling with heroin addiction, or if you’ve released after seeking treatment, speak to an addiction treatment specialist at Ocean Breeze Recovery to learn more about your options. It’s important to note that even people who have relapsed many times can achieve lasting recovery.
Addiction is difficult to overcome for many people, but you don’t have to go through it alone. Call 855-960-5341 to learn more about the medication-assisted treatment option and how it can help you achieve lasting sobriety and freedom from active heroin addiction.
National Institute on Drug Abuse. (2018, July). Treatment and Recovery. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
SAMHSA. (2015, July 21). Medication-Assisted Treatment (MAT). Retrieved from https://www.samhsa.gov/medication-assisted-treatment
U.S. Food and Drug Administration. (2019, February 14) Drug Safety and Availability. Information by Drug Class. Information about Medication-Assisted Therapy. Retrieved from https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
Drugs.com. (2019, October 1) Narcan. Retrieved from https://www.drugs.com/narcan.html
Drugs.com. (2019, November 1) Methadone. Sinha, S., MD Retrieved from https://www.drugs.com/methadone.html
Drugs.com. (2019, August 16) Naltrexone. Cerner Multum. Retrieved from https://www.drugs.com/mtm/naltrexone.html
SAMHSA. (2015, June 15). Buprenorphine. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine