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At Fresh Start Health we treat opioid addiction because we understand why other approaches fail. Opioid addiction is a substance use disorder, which is a chronic disease that is called Opioid Use Disorder . It is not caused by a moral falling. OUD rewires an individuals brain, and this makes it harder for people to quit. It has to be treated like other chronic diseases, and not all treatment programs do that.
If youre suffering from addiction, you understand how this disease can destroy your life. You understand how hard it is to quit, even after trying and trying again. There is no single path that is correct for everyone. However, research shows that individuals who seek recovery are more successful when they engage in medication-assisted treatment , with behavioral counseling and a reliable network of support.
What Does Mat Treat
The average MAT program in Los Angeles treats addiction to opioids, such as those found in some prescription pain relievers and heroin. It can also be utilized in alcohol addiction treatment. Medications used during treatment block the euphoric effects of opioids and alcohol, normalize brain chemistry, relieve cravings, and normalize functions of the body.
Mat Medications For Alcohol Use Disorder
MAT therapy for AUD involves one of three medications: disulfiram, acamprosate, and naltrexone. Like MAT treatment for OUD, each of these medications must be accompanied by therapies and other evidence-based interventions tailored to the individual.
Disulfiram
Disulfiram works by creating unpleasant side effects when a person taking it decides to drink. Even after consuming a little bit of alcohol, a person can experience side effects such as nausea, vomiting, diarrhea, vertigo, flushing, headache, and heart palpitations. The effects can last for an hour or more and are intended to keep the individual from drinking. In order for disulfiram to work, a person must be committed to the treatment schedule and staying sober. It can be particularly useful for triggering social situations like parties.
Acamprosate
Acamprosate is intended to prevent relapse for an individual newly in sobriety. It is especially helpful in the treatment of Post-Acute Withdrawal Syndrome . PAWS can occur anytime within the first two years of treatment and is believed to be the result of changed brain chemistry during the period of heavy alcohol use. Specifically, neurological adaptations in neurotransmitter systems like the GABA system can lead to hyper-excitability. Acamprosate can calm this hyperactivity and reduce the symptoms that result, such as insomnia, restlessness, and anxiety.
Naltrexone
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Mat Can Be Part Of A Greater Framework
Clinical settings typically offer MAT as a standalone program. In an average program, patients receive their medications and get a choice between individual or group counseling, as well as some referrals to local resources. These tools can be enough to help someone enter and sustain Recovery, but MAT has much more substantial potential.
In more robust and patient-centered programs, any number of holistic therapies can support MAT and further unlock its potential. It is particularly powerful for Opioid Addiction, as the elimination of withdrawal symptoms allows patients to engage with the full range of holistic therapies available.
Mat Meets Telepsychiatry And Telebehavioral Health In North Carolina
Dr. Jay Shore, chairperson for the American Psychiatric Associations Committee on Telepsychiatry
The American Psychiatric Associations Committee on Telepsychiatry chairperson, Dr. Jay Shore, said since providing MAT medication services involve prescribing controlled substances, telepsychiatry has one significant challenge for MAT-prescribing psychiatrists: the law.
The Ryan-Haight Act requires an in-person visit before prescribing medications like most of those used for MAT, Shore said. Right now, whats being offered by psychiatrists through telehealth connections is education.
But MATs counseling services can be delivered with virtual connections. Mission Health, in Asheville, North Carolina, is a hospital system that serves 18 counties , five hospitals ), and has several rural primary care clinics. In a June 2017 National Rural Health Resource Center webinar, the organization detailed how its telebehavioral healths blended model meets distance practice needs like those in CAH emergency rooms and on medical floors. Their model was adapted to now provide the clinical counseling portion of MAT treatment.
When MAT is needed in primary care, it might be important that your communities understand that treatment is in the context of comprehensive primary care, not a stand-alone service, Boice said.
Mission Hospital in Asheville, North Carolina, part of Mission Health
Addressing MAT Controversies
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Misconceptions With Medication Assisted Treatment
Doctors use medications like buprenorphine in MAT. These medications help to suppress cravings. They also give newly recovered patients a much stronger chance at remaining drug-free in their first year. This buys them valuable time for self-growth. Time to attend therapy and to participate in fellowships and build a personal form of recovery that will help sustain them in the years ahead. One of the obstacles to MAT in the past, and today, has been the misconceptions we touched upon earlier. These include:
- The idea that someone on MAT isnt sober.
- Some people believe that MAT interferes with recovery somehow.
- The idea that MAT is a cop-out or not the correct way of doing things.
All of these are misconceptions. The reality is that MAT delivers results and it has undoubtedly saved lives. It is important that it be presented and available as an option for treatment whenever appropriate. MAT also includes more than just medication. It is a systemic form of care that incorporates group and sometimes individual therapy, goal setting, evaluation and support.
Three Medications Are Currently Approved By The Fda To Use For Mat: Buprenorphine Naltrexone And Methadone
According to the American Society of Addiction Medicine, no matter which medication is prescribed the goal is the same: getting the patient to feel normal, have little to no side effects or withdrawal symptoms, and have controlled cravings for opioids.
Buprenorphine is a partial opioid agonist. That means it binds to and activates opioid receptors in the brain, but with less intensity than full agonists. It can reduce cravings and withdrawal symptoms, but does not produce the level of euphoria found in heroin and prescription pain relievers. Buprenorphine is most commonly prescribed in a clinical setting, It also blocks other narcotics while reducing withdrawal risk and is available as a daily dissolving tablet, cheek film, or 6-month implant under the skin.
- Suboxone® Contains both buprenorphine and naloxone. Because it is formulated with naloxone which reverses opioid overdoses it also reduces the potential of misuse. If a person were to take more Suboxone than prescribed, they would also receive more Naloxone. , and one is less likely to experience sudden withdrawal than with Vivitrol. Some also say it is more effective than Vivitrol.)
- Subutex® Only contains buprenorphine,and does not contain Naloxone.
- Methadone clinic-based opioid agonist that does not block other narcotics while preventing withdrawal while taking it daily liquid dispensed only in specialty regulated clinics.
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Issues On Potential Dependency On Another Drug
Some people question the safety and effectiveness of prescription drugs used as a part of the rehab program. They cite a number of cases where people became dependent on replacement drugs. They acknowledge that replacement drugs may reduce the substance misuse but note that the unsupervised use of replacement prescriptions can create addictions themselves.
It is important to note that the main purpose of these medications is not to start a new addictive habit but to aid in substance abuse cessation. Prescription medications work in various ways, but all aim to reduce the discomforts of withdrawal or to prevent substance dependency by blocking its effects. To reduce misuse and risk of developing an addiction to MAT, individuals should follow the directions of their medical providers. If an individual feel like he or she needs more MAT treatment, he or she should consult with the prescribing medical provider rather than adjust the dosing themselves.
Moud And Mat For Opioid Addiction Treatment
The bottom line is that MOUD saves lives. But stigma stands in the way of people getting this life-saving treatment. Using the term MOUD for opioid addiction treatment may seem like a small step. But just one word can do a lot to shift public perception. As MOUD becomes connected with medical treatment, the stigma about treatment can begin to erode. If you need to learn how MOUD or MAT could help you or a loved one, call us at our P.A.T.H. clinic.
We can help. Contact us today at 713.528.3709.
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Mat At 7 Summit Pathways
At 7 Summit Pathways, we use elements of both MAT and MAR. We have built our approach on the foundational knowledge that Addiction consists of learned behaviors outside the patients control. It results in extreme changes to brain chemistry and the way the brain functions, and the effects depend on the type of substance used. Generally, however, Addiction results in long-lasting brain changes.
Most people are aware of withdrawal, which comprises all the painful symptoms that come with cutting off the brains supply of alcohol or drugs. Typical symptoms of withdrawal from drugs or alcohol include:
- Appetite changes
- Impaired cognition
At 7 Summit Pathways, our Medical Director, Dr. Lawrence Wilson, is well-versed in the challenges posed by PAWS. With an in-depth evaluation of each patient, Dr. Wilson builds a completely personalized treatment plan designed around your goals and desires. When appropriate, your treatment team will encourage you to continue your specific medication protocol anywhere from six to 12 months after the completion of your initial treatment. The first year after treatment completion is crucial in establishing healthy patterns in Recovery.
The door is always open. After you complete treatment at 7 Summit Pathways, you are welcome to return to us anytime to address your continued medication-assisted Recovery and develop a medication exit strategy as you continue to grow stronger in Recovery.
What Is The Asam Criteria
The ASAM Criteria is the most widely used and comprehensive set of guidelines for placement, continued stay, transfer, or discharge of patients with addiction and co-occurring conditions. Formerly known as the ASAM patient placement criteria, The ASAM Criteria is the result of a collaboration that began in the 1980s to define one national set of criteria for providing outcome-oriented and results-based care in the treatment of addiction.
Many states across the country are using The ASAM Criteria as the foundation of their efforts to improve the addiction treatment system. Adolescent and adult treatment plans are developed through a multidimensional patient assessment over five broad levels of treatment that are based on the degree of direct medical management provided, the structure, safety and security provided, and the intensity of treatment services provided.
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Pros And Cons Of Medication Assisted Treatment
Like any other treatment option, medication assisted treatment comes with both benefits and risks. The primary benefits include reduced chance of relapse and overdose, in addition to decreased use of substances and reduced rates of infectious disease transmission. Possible risks are the side effects of each medication. Individuals may need time to get acclimated to each medication and may experience symptoms such as nausea, headache, or dizziness. The severity and nature of these symptoms will depend on the medication selected and the individuals tolerance. In some cases, relapse could lead to fatal respiratory distress since the body is no longer acclimated to opioids. This particularly pertains to the use of naltrexone in the treatment of opioid use disorder. Make sure to talk through all the benefits and risks of MAT medication with your own healthcare provider before committing to any regimen.
What Is Medication Assisted Treatment
Medication-assisted treatment is the use of medications, approved by the Food and Drug Administration , in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders.
When it comes to medication, the most commonly used are antagonist drugs, they are sometimes called blockers, which main function is to interfere on the receptors where a substance do its action. As an example, Narcan , is a medication used to block the effects of opioids.
An agonist drug activates the same sites that an addictive substance would bind to. Drugs used in MAT are usually partial agonists, providing only partial efficacy relative to a full agonist and often producing side effects similar to opioids misuse for this reason combined drugs are frequently used, such as Suboxone, which is a combination of Buprenorphine and Naloxone. Buprenorphine reduces the opioids withdrawal symptoms while the Naloxone prevents the high effects of Buprenorphine.
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A Framework For A Potential Solution
Informed consent and voluntariness are of concern in medical and socio-behavioural research with human subjects . These complex processes are implemented, and are mandatory in most cases, to protect vulnerable participants from being influenced, potentially against their will or best-interests, to participate in research studies. Though several decades in the past, the influence of the Tuskegee and Holmsberg Prison experiments, among others studies conducted on a coerced or uninformed prison population , can be seen reflected within the requirements for research with justice-involved and other vulnerable populations .
MAT-focused programs, especially those using long-acting medications like injectable naltrexone, must take into account that drug courts, and the criminal justice system generally, present a complicated environment for addiction treatment delivery. In this sensitive setting, relapse or failure to comply with treatment may subject defendants to additional punishment. This may constitute a form of undue influence in some cases.
Coviello et al. illustrate the importance of following best-practices in their description of efforts to recruit subjects for a study on another preparation of extended-release injectable naltrexone. In that instance, they sought to recruit a convenience sample of probationers and parolees. They note that, when speaking with potential participants:
How Does Mat Help With Opioid Addiction
People who have been abusing opioid drugs and abruptly stop will experience withdrawal symptoms. The symptoms are so unpleasant that many people start taking the drugs again. People in the midst of an opioid withdrawal syndrome will also experience extreme cravings to take their drug of choice.
MAT works to:2
- Reduce uncomfortable withdrawal symptoms using an opioid replacement medication. The medications help to lower the risk of relapse during the early stages of recovery.
- Address cravings for the drug in the early stages of recovery.
- Facilitate a slow, controlled taper of the drug so that the person can adjust to living without opioids.
- Provide medical supervision of the early stages of the persons recovery. Supervision can be extremely helpful in addressing triggers and potentially stressful situations that can increase the probability of relapse.
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Everything You Need To Know About Medication
Medication-assisted treatment is a highly controversial topic amongst individuals in recovery as well as medical professionals. When choosing the most appropriate substance abuse treatment program, patients should remain vigilant and educate themselves. Addiction recovery is not a one size fits all path. One method of treating substance use disorder may be effective for one person, while ineffective for another.
Although MAT can be a useful component of a successful recovery program, stigmas have contributed to this method of treatment being underutilized. MAT should be one component of treating substance use disorder while including behavioral interventions such as therapies and support group participation. The goal of medication-assisted treatments is to control a specific set of conditions during the early stages of recovery. Once the conditions are addressed, the individual should taper off the medication as they replace negative coping skills with functional behaviors.
Your Personal And Professional Life Can Suffer
An addiction can quickly take over your life. It can ruin relationships, cause financial difficulties, and lead to job loss. Chasing relief can become the only thing that matters, and everything else falls by the wayside. Then, you may resort to using more to cope with the emotional stress of losing everything that was once important to you.
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What Is Harm Reduction
Harm reduction is a combination of practical strategies and ideas to reduce the harmful consequences associated with drug use. It is also a movement for social justice built on a belief in and respect for the rights of people who use drugs. Rather than ignoring that society will always have a certain level of drug abuse issues, harm reduction chooses to accept this reality so we can minimize the physical, social, and psychological harms that result from drug use.Logan, D. E., & Marlatt, G. A. . Harm reduction therapy: A practicefriendly review of research. Journal of clinical psychology, 66, 201-214. The ultimate goals of harm reduction tactics are to improve drug users health and well-being and reduce the injuries and deaths associated with drug use and problematic drug use behaviors.
Some common harm reduction strategies include:
- Providing sterile needles or syringes to people who inject drugs
- Offering free or low-cost testing for HIV and other STDs
- Making naloxone more widely available
- Providing safe places for people to use drugs under medical supervision
- Offering counseling and other support services to people who use drugs
Mat Medications And Child Safety
Its important to remember that if medications are allowed to be kept at home, they must be locked in a safe place away from children. Methadone in its liquid form is colored and is sometimes mistaken for a soft drink. Children who take medications used in MAT may overdose or experience adverse reactions.
Prevent children and pets from accidental Ingestion by storing it out of reach. For more information, visit CDCs Up and Away educational campaign. For information on how to dispose of medications in your house, refer to FDAs information How to Safely Dispose of Unused or Expired Medicine or DEAs drug disposal webpages.
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