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Medication-Assisted Treatment for Opioid Addiction

7/24/2014

 
Picture
This blog was written by:
Patti Waits, 
M.Ed., LPC, LICDC (ADAMH Consumer and Family Advocate)

I was always kind-of skeptical about Methadone clinics before I attended a training on this topic at the recent Opiate Summit in Columbus. The presenter was a psychiatrist named Dr. Christina Delors Reyes from the Center for Evidence Based Practices at Case Western Reserve University. While her credentials were impressive, what really stuck out to me was how down-to-earth and easy she made the topic. She pointed out that there are lots of myths around the clinics.  Addicts are given the methadone by drinking a liquid in front of a nurse.  For them to try to save it and sell it would be really hard to do.  A person would have to put a cotton ball in his or her mouth to absorb the liquid, hold it there, and talk as if nothing was going on. Then they would have to go out into their car in the parking lot and spit it back out and squeeze out the liquid into a container. Then they would have less than a thimble-full to sell to whomever would be willing to purchase second-hand Methadone. 

She said that while Methadone is seen by some people as “another drug to which people are addicted” people who are treated with it do not have the same criminal behaviors as addicts on the street. Most of them go back to work and their families and lead normal lives. Aside from the misconceptions, one of the real barriers to this type of treatment is the fact that people have to drive to a clinic 6 days a week to get their dose of Methadone. There are not clinics in every city or town, and sometimes they must drive a long way to get to one.

She also talked about Suboxone and the fact that doctors have to have specialized training to prescribe it. I thought that was interesting because they don’t have to have additional training to prescribe other “addictive” drugs such as Percocet, Vicodin, or Xanax.  Dr. Delors Reyes feels the laws about Suboxone have made it more difficult for addicts to access this kind of help. Doctors are required to have an 8 hour training and they are limited to only treating 30 patients at a time.

The other drug that she talked about was Naltrexone (Vivotrol). She mentioned that the cost for the shots was about $ 1,000 a month, and that the shots really hurt. She said that Vivortrol works well for highly motivated clients who have external circumstances and are reporting to a judge or probation officer, such as impaired professionals, parolees, or probationers.  One caution about this medication is that it "blocks" the opiate receptors in the brain and causes the patient's tolerance for drugs to “reset”. If they return to drug use at the same levels they were previously using, they will be at a high risk of overdosing due to their lowered tolerance. 


So while I was once skeptical about Medication Assisted Treatment, I think that attitude was really a result of my ignorance on the topic. It seems like this is another tool for the recovery toolbox.  I would encourage anyone interested to find out more information about this topic.

For additional information you can email Dr. Reyes at: ChristinaDelorsReyes@uhhospitals.org or contact the Fairfield County ADAMH Board.



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