If you are asking yourself, “Is MAT the right recovery option for me?” You will also have to ask yourself which MAT option is best. This includes MAT that utilizes Vivitrol and MAT that includes the use of Suboxone.
The key to utilizing these medications is to rely on medical professionals. When it comes to recovery, it is critical to rely on the help of medical professionals and addiction specialists. Based on your needs and specific circumstances, they will be able to determine which medication is best. Staying connected to recovery professionals is how you can determine if a medication is working. It is not uncommon to switch from one medication to the next based on initial efficacy.
It is also important to determine long-term plans for recovery. For example, MAT may not be a long-term solution. Perhaps it is the first step toward an abstinence program. MAT may be used in the short term, and then you may want to switch to a community program like 12-Step or SMART recovery. The key is to connect with professionals and stay connected throughout your recovery journey.
Understanding Medication-Assisted Treatment Options
So, what exactly is medication-assisted treatment (MAT)? A basic understanding is that it is a recovery option that does not require complete sobriety (by the definition of substance-free recovery).
According to the Journal of Primary Care & Community Health, “Medication-assisted treatment (MAT) is the pairing of psychosocial intervention with a Food and Drug Administration (FDA)–approved medication (methadone, buprenorphine plus naltrexone) to treat OUD. MAT has resulted in reductions in overdose deaths, criminal activity, and infectious disease transmission. Access to MAT in rural areas is limited by shortages of addiction medicine-trained providers, lack of access to comprehensive addiction programs, transportation, and cost-related issues.” While there are other forms of MAT, the primary form of MAT is used to treat opioid use disorder (OUD).
There are very specific medications approved by the United States Food and Drug Administration (FDA) for MAT. According to the FDA, “There are three medications approved by the FDA for the treatment of OUD: buprenorphine [including Suboxone], methadone, and naltrexone [including Vivitrol]. All three of these treatments have been demonstrated to be safe and effective. The FDA is working to identify treatment needs, expand access to treatment of existing MOUD, and promote the development of new options for evidence-based treatment for OUD.”
An Epidemic: Understanding Opioid Use Disorder
The reality is that an opioid epidemic is ongoing. This is true both in the U.S. and around the world.
According to the peer-reviewed journal, Cureus, “Opioid use disorder (OUD) is a growing public health problem affecting over 2.1 million people in the United States alone. The total overdose deaths attributed to opioid involvement rose from 46,802 in 2018 to 68,630 in 2020, while those attributed specifically to prescription opioids increased from 14,139 in 2019 to 16,416 in 2020. Synthetic opioids other than methadone, mainly fentanyl, have primarily driven drug-involved overdose deaths from 2015 to 2020, which increased six-fold over this period.” So what exactly is OUD?
According to the peer-reviewed thesis, Opioid Use Disorder: Evaluation and Management, by Doctors Dydyk, Jain, and Gupta, “Opioid use disorder (OUD) is defined as the chronic use of opioids that causes clinically significant distress or impairment. Symptoms of this disease include an overpowering desire to use opioids, increased opioid tolerance, and withdrawal syndrome when opioids are discontinued. Thus, OUD can range from dependence on opioids to addiction.” It is also important to understand that OUD is a disease that has very specific signs and symptoms.
The Signs and Symptoms of Opioid Use Disorder
Now, of course, the signs and symptoms of OUD are going to be based on the individual and specific circumstances surrounding their addiction. For example, “How long have you been using opioids?” and “How often do you use opioids?”
However, there are some universal signs and symptoms that you can look out for if you think you or a loved one is struggling with OUD. The following are a few of those signs and symptoms:
- Losing interest in activities once enjoyed
- Feeling anxious, nervous, or overly “stressed out”
- Loss of appetite and a lack of care regarding physical appearance and well-being
- Exhibiting excessive mood swings
- Isolating away from family and close friends
- Experiencing trouble at work or school
- Having trouble with sleep cycles, including sleeping too much and not sleeping enough (hypersomnia and insomnia)
- Having feelings of worthlessness, hopelessness, and helplessness
- Not being able to stop once starting to use opioids
- Experiencing physical ailments such as headaches, body aches, and gastrointestinal problems
- Engaging in risky behaviors
- Causing harm to oneself or others
- Having suicidal ideations
Now, as you can see, these signs and symptoms are significant and can even be deadly. This is why reaching out for professional help as soon as possible is crucial. Doing so could mean the difference between short-term side effects and long-term consequences. Also, this is the first step toward MAT (if that is the right path for you). This may involve the use of Vivitrol.
An Overview of Vivitrol
Vivitrol is a brand of a medication known as naltrexone. So, what exactly is naltrexone, and how can it be beneficial for recovery?
According to the peer-reviewed thesis, Naltrexone, by Doctors Singh and Saadabadi, “Medications used to treat alcohol and opioid use disorder focus on altering their reinforcing effects on inducing euphoria. Naltrexone (and its active metabolite 6-beta-naltrexone) is pharmacologically effective against alcohol and opioids by blocking the mu-opioid receptor… Naltrexone blocks the effect of opioids and prevents opioid intoxication and physiologic dependence in opioid users.” This last component is key. Naltrexone stops the intoxicating effects experienced when using opioids. This is critical because it reduces the chances of overdose that can happen with other forms of MAT.
Compared to other MAT options, Vivitrol is much less likely to lead to an overdose or overdose death. According to the peer-reviewed journal, Cerebrum: The Dana Forum on Brain Science, “Practically speaking, heroin-dependent patients, if compliant with methadone, are able to work, have relationships, and lead productive lives. While methadone is an agonist (binds to opioid receptors and is addictive), it seemed to quell cravings. Nevertheless, the drug must be dispensed at a licensed clinic and requires careful monitoring; it is liable to abuse and diversion and, if combined with other sedating drugs (e.g., barbiturates, benzodiazepines, alcohol), can lead to overdose and death.”
An Overview of Suboxone
Suboxone is a brand-name of the class of medications known as buprenorphine. It can also be highly effective for treating OUD.
So what exactly is Suboxone? According to the peer-reviewed thesis, Buprenorphine, by Doctors Kumar, Viswanath, and Saadabadi, “Buprenorphine is categorized as a Schedule III drug, which means it has a moderate-to-low potential for physical dependence or a high potential for psychological dependence. Buprenorphine is approved by the U.S. Food and Drug Administration (FDA) to treat acute and chronic pain and opioid dependence. This drug is used in agonist substitution treatment—a method for addressing addiction by substituting a more potent full agonist opioid, such as heroin, with a less potent opioid, such as buprenorphine or methadone.”
This is the biggest difference between Vivitrol and Suboxone; you still get euphoric effects from Suboxone. This also means that Suboxone has a much higher potential for misuse. This is why it must be used with other therapies. According to the peer-reviewed journal, Health Psychology Research, “Since 2000, the Drug Addiction Treatment Act has allowed buprenorphine to be used for Opioid Use Disorder as medication-assisted treatment. Buprenorphine should be used in combination with therapy and counseling. The comprehensive approach to treatment provides more opportunities for patients to successfully treat their disease or prevent further withdrawal or relapses in the future.” Also, many people don’t realize just how common relapses can be.
The Benefits of MAT
There are many benefits of MAT. Of course, the pros and cons must be weighed, based on your specific situation.
Perhaps the biggest benefit of MAT is that it stops the individual from fully relapsing with recreational opioids. Also, relapses are highly prevalent both in the U.S. and around the world. According to the peer-reviewed thesis, Addiction Relapse Prevention, by Doctors Guenzel and McChargue, “One primary concern in addiction treatment is the high rate of relapses within a short period after even the most intensive treatment. Many studies have shown relapse rates of approximately 50% within the first 12 weeks after completion of intensive inpatient programs that often last 4 to 12 weeks or more and can cost tens of thousands of dollars.”
There are also many other benefits of MAT. The following are just a few of those benefits:
- Reduced cravings and withdrawal symptoms
- Alleviation of opioid-induced physical ailments
- Potential for financial stability from recreational opioid use
- Reconnection with friends and family
- Helps with mental and cognitive stability
- Reduces mood swings
- Reduced struggles at work and school
- A reduction in risky and dangerous behaviors
- Opens up the potential for spiritual growth
Who Is MAT For?
Ultimately, MAT is for anyone who is struggling to quit recreational opioid use with abstinence. However, due to the potential for misuse, MAT must also be considered in the care of medical professionals and addiction specialists.
MAT is especially effective for individuals who struggle with “chronic relapsing.” These relapses often occur because the physical and mental anguish associated with opioid withdrawal is too painful to continue with sobriety. These substances help with those withdrawal symptoms. MAT also helps connect you to other means, methods, and modalities of recovery. These should be used in tandem with MAT for the best chances of success.
MAT Alone Is Often Not Enough
The multi-angled approach to recovery is often the best path. This is because utilizing many modalities just increases the chances of success.
This is because most recovery treatments work to supplement and support one another. For example, psychotherapy is often the evidence-based foundation of most recovery plans. This is because it gets to the critical underlying issues of addiction. It is important to remember that opioid addiction is not just about the substance, but rather, it is about the reason you use the substance in the first place; the “why.”
MAT and Psychotherapy
There are many effective forms of psychotherapy that can help with addiction. Perhaps the most commonly used psychotherapy for addiction is cognitive-behavioral therapy (CBT).
CBT can be particularly effective because it gets to those underlying issues of addiction that were previously mentioned. CBT can also help you to see the negative way in which you have been viewing yourself and the world around you. It then helps you to change these views and thus change the behaviors associated with them.
CBT is particularly effective when used with other types of treatment. According to the peer-reviewed journal, Substance Abuse and Rehabilitation, “Robust evidence suggests the efficacy of classical/traditional CBT compared to minimal and usual care control conditions. CBT combined with another evidence-based treatment, such as Motivational Interviewing, Contingency Management, or pharmacotherapy, is also efficacious compared to minimal and usual care control conditions, but no form of CBT consistently demonstrates efficacy compared to other empirically-supported modalities. CBT and integrative forms of CBT have potential for flexible application, such as use in a digital format.”
MAT and Experiential Therapy
Many people who struggle with OUD also struggle with isolation. This is the nature of the disease – it wants you alone and using.
Experiential therapy is an ideal way to break out of isolation and learn to have new experiences in addiction recovery. One can better connect with oneself by connecting to nature. Surfing is a great type of experiential therapy with a myriad of different benefits for recovery.
Surf therapy offers physical, emotional, mental, and spiritual benefits. According to the International Journal of Environmental Research and Public Health, “Carefully planned water activities tailored to the needs of the individual can contribute to correct psychosocial and cognitive development. The International Surf Therapy Organization summarizes the benefits of adequately indicated surf therapy as follows: improved physical health and mobility; improved mental health, including reduction of specific symptoms, such as posttraumatic stress and depression; improved well-being (strengthening of trust and confidence, encouragement of independence, resilience, and protective coping strategies), and improved social skills.” There are also many holistic options that effectively supplement MAT.
MAT and Holistic Healing Methods
Holistic healing methods like yoga therapy and mindfulness meditation are ideal for long-term recovery. They can also be utilized anywhere, both individually and in groups.
The iconic spiritual leader and yogi B.K.S. Iyengar famously said, “Yoga allows you to rediscover a sense of wholeness in your life, where you do not feel like you are constantly trying to fit broken pieces together.” Yoga and meditation have been practiced for thousands of years. Initially, they were used solely for spiritual and/or religious purposes, but they have since moved into the realm of recovery.
Mindfulness meditation can offer many benefits as one also utilizes MAT. According to the International Quarterly Journal of Research in Ayurveda, “In this state [meditation], dualities such as pleasure and pain, good and bad, etc., are not experienced. There is no experience of stress, anxiety, guilt, greed, envy, jealousy, anger, etc. The only experience in this state of unity is peace and bliss.”
A Focus on Long-Term Success at Hawaii Island Recovery
Here at Hawaii Island Recovery, we believe in long-term success over short-term “fixes.” That is why all of our plans are individualized and comprehensive, with a focus on the future. This includes plans that begin with a program of MAT.
Vivitrol and Suboxone are two popular medication-assisted treatment (MAT) options for opioid dependence. For those looking to recover, it is important to know how each medication works, their benefits, potential side effects, and eligibility criteria. There are also other options for recovery. You got this! For more information about MAT and other recovery options, please reach out to Hawaii Island Recovery today at (866) 390-5070.
