Medication-Assisted Treatment: A Solution to the Statistics?

A three-part series by Guest Blogger Gloria Englund, MA

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Part III

The availability and use of Suboxone is very different now than when Aaron’s final attempt at recovery took place. Then, health insurance paid for Suboxone only when it was administered through an in-patient treatment facility. It was used mainly as a detox tool, not a recovery treatment tool as it is now. Many addiction specialists now recommend that patients with an opioid addiction may be best served with indefinite MAT therapy.  There were not many treatment centers licensed to dispense it and very few doctors licensed to prescribe it. This continues to be a challenge in the treatment world. Many physicians still choose not to seek licensure to dispense Suboxone because they don’t want to deal with the population of people ill with a substance use disorder. Another way the stigma and discrimination still play into the availability of MAT.

True Recovery

I used to think complete abstinence from methadone, buprenorphine (Suboxone), or naltrexone used in MAT, was the only marker for true recovery.

Everything I have learned about SUD and recovery since Aaron’s death tells me that I had a very narrow and uneducated view of what may be necessary to keep the person with an opioid use disorder alive so recovery can happen.

The more options available for MAT to those with SUDs who seek recovery, the better are their chances of remission and the more lives we save.

Since Aaron’s death, I have seen and heard many testaments to the effectiveness of all three of these medications when they are used as recovery tools. But the availability, cost and insurance coverage needs to align in support of these life-saving medications that can prevent overdose deaths.

Evidence-Based Treatment

It’s imperative to remember that MAT programs are evidence-based treatment (EBT) protocols. This means there’s scientific research to back up the practice of medication-assisted treatment as a viable treatment option. In general, the research proves that people on MAT have fewer relapses, live longer and stay in recovery longer than those who do not use it. This is especially true for those with opioid use disorder.

We Need More Education & Information

I believe lack of education about addiction being a brain illness and the public not being properly informed about the life saving properties of MAT is what killed Prince along with the additional 128 people who died of a drug overdose on April 21, 2016. Chronic pain might have brought him to where he was with his illness, but in my opinion, ignorance and stigma kept Prince and those close to him from asking for the right kind of the help, at the right time.

This is the third of a three-part series. We are posting the full series in the Resource section of Our Young Addicts.

Saving the lives of those who are ill from this disease will only happen when the general public becomes educated and demands that the people who suffer from these disorders, deserve the same medical treatment and compassion as does anyone suffering from a chronic illness.

About our Guest Blogger: Gloria Englund, founder of Recovering u breaks new ground in the field of addiction recovery and support. As an ally of the recovery community, she honors all pathways of recovery. She is a psychotherapist, who holds a Master of Arts degree in Human Development. As a certified Recovery Coach, she works with individuals and families dealing with an addiction to alcohol, drugs, food, and relationships. Gloria has personal as well as professional knowledge of addiction and recovery; her oldest son, Aaron, died of a heroin overdose in 2007. As an accomplished public speaker, advocate and published author, Gloria brings a message of hope and recovery to others.

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

Medication-Assisted Treatment: A Solution to the Statistics?

A three-part series by Guest Blogger Gloria Englund, MA. New Protocols, Addiction as a Progressive Brain Disease.

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Part II

Old-school Perception & Protocol – the 1990s

My history with MAT goes back to the 1990s when most people considered substance use disorders a character flaw, and/or lack of will power and motivation. Although the American Medical Association (AMA) recognized alcoholism as disease in 1956 which allowed it to be viewed as a diagnosable condition for which insurance reimbursement was possible, most treatment focused on it being a psychological/behavior disorder. This was the treatment protocol I learned in graduate school in the early ‘90s.

Addiction Recognized as a Progressive Brain Disease

Aaron died in 2007.  It wasn’t until 2011 that The American Society of Addiction Medicine (ASAM) first stated that addiction is a progressive brain disease that is fatal without intervention.

This meant both of us went through our 20-year struggle with his SUD without knowledge of addiction being a brain disease – as I suspect many have. It was a wake-up call for me to learn that this illness is about underlying neurology, not outward actions.

The NIDA soon after stated that addiction is “a chronic relapsing …brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”  It was so hard for me to grasp that my son’s was ill not only with a physical dependence – but also a psychological compulsion that would create drug seeking behavior no matter what the consequences.

Abraham Maslow’s Hierarchy of Needs is a theory of psychological health predicated on fulfilling innate human needs in a specific priority. Physiological needs such breathing, food and water are at the bottom the hierarchy. In other words – a human’s first priority is sustaining life. The hierarchy culminates in self-actualization at the top. The compulsion that is characteristic of SUD precludes those basic physiological needs.

This is why many need MAT to get their cravings quelled. If the cravings aren’t under control, they can’t even think about meeting those basic needs of life – so they can go on to recovering their life.

Tapering Off or Long-term Maintenance?

In 2007, most people on MAT methadone programs were encouraged to start tapering off the medication once they had been stabilized for weeks or a few months. The yo-yo effect of trying to taper and failing to find the correct dosage created constant turmoil for Aaron as well as frequent relapses. At that time, both of us attended recovery support groups which promoted that if you were on medication-assisted treatment you weren’t really in recovery because you were still using an opioid medication. And this continues to happen today.

Very few supportive services were offered along with Aaron’s MAT program – which I now know is very important to recovery. You can’t just take a pill or get an injection and recover from this illness. Although behavior and psychological issues may not be a CAUSE of this illness, they do result as we try to SURVIVE the illness.

That’s why MAT needs to be offered along with individual or group therapy, peer recovery support groups, classes on exercise, nutrition – basic life skills – keeping a budget and learning how to seek employment.

Minnesota Recovery Connection, like many other recovery community organizations (RCO) in other states – offer many of these resources on their website and support all pathways to recovery.

Note to readers: Part III will run on Thursday, June 30. We will post the full three-part series in our Resource section.

About our Guest Blogger: Gloria Englund, founder of Recovering u breaks new ground in the field of addiction recovery and support. As an ally of the recovery community, she honors all pathways of recovery. She is a psychotherapist, who holds a Master of Arts degree in Human Development. As a certified Recovery Coach, she works with individuals and families dealing with an addiction to alcohol, drugs, food, and relationships. Gloria has personal as well as professional knowledge of addiction and recovery; her oldest son, Aaron, died of a heroin overdose in 2007. As an accomplished public speaker, advocate and published author, Gloria brings a message of hope and recovery to others.

Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.

Three-part MAT Series 6/16, 6/23 & 6/30

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It’s about time we talked more about Medication-Assisted Treatment (MAT), and it starts with straight information and open-minded consideration. The next three Thursdays, we will run a series by Guest Blogger Gloria Englund, MA, from Recovering U.

  • June 16 – Defining MAT; Learning about Suboxone, Methadone and Naltrexone
  • June 23 – Ditching old-school perceptions and protocols; Looking at addiction as a progressive brain disease
  • June 30 – True recovery; Evidence-based treatment

We will post the full series as a printable pdf on the Resource section of Our Young Addicts.

Midwestern Mama