Pharmacological Treatment for Opiods: Good or Bad?

The opioid crisis kills over 800 people a week from overdose in the United States. Drug overdose is now the leading cause of accidental death in the U.S., and opioid addiction is driving this epidemic.  

Beyond death and overdoses, opioid misuse has a significant socioeconomic impact, from contributing to the spread of diseases like HIV and Hepatitis, to addict in ability to hold down a job leading to a rise in unemployment. Use during pregnancy can have lasting health effects on the child once born, continuing and expanding the impact.

Opioids are the group of drugs derived by the opium poppy plant. Both legal and illicit forms exist and contribute to the opioid crisis. Heroin is the most synonymous opioid, especially when one thinks overdoses and the opioid epidemic.  But other legal forms of opioids contribute to the epidemic and treatment, such as oxycodone and hydrocodone and fentanyl, used to treat pain, as well as methadone and buprenorphine, which are used in opioid addiction treatment.

One might question the use of an opioid to treat addiction to opioids, but the treatment has been around for decades and has proven quite successful, especially in conjunction with group or individual therapies. These therapy programs are known as Medication Assisted Treatment (MAT) or pharmacotherapy, and help address all aspects of opioid addiction.

Currently it is believed only fifty percent of opioid addicts utilize medical treatment for their addiction.

How Drugs Assist Treating Drug Addiction

First it’s important to acknowledge addiction is a disease. There are genetic predispositions, as well as influence from how the brain is wired, that make it more likely for individuals to have addictive tendencies.  The use of the substances alter the brain wiring even further. Those who abuse substances often do so because of the chemical reactions the substances produce, most often dopamine. Continued use alter these “reward pathways” cementing the addiction. Treatment must target the parts of the brain that have changed. Because of these biological factors, it’s important to consider the struggle individuals with addiction face with the neurological and physiological changes they’ve had with medication.

Many ask, isn’t pharmacotherapy just replace one addiction for another?

It’s not- because during treatment, with the appropriate dose, the medicine does not produce a “high”. Instead it addresses craving and withdrawal symptoms by activating the receptors that reinforce the addiction, while helping repair the damage caused by the addiction. This helps the individual heal while controlling symptoms so they way work their way to recovery.

How OUD Medications for opioids work in the brain illustration

Does it Help?

Statistically, yes, when areas allow MAT services, they see less overdoses compared to those with only psychological treatment.

Vermont is a great example of the success of medicated treatment. Vermont residents with opioid addiction are given access to MAT and buprenorphine. France also saw a decline in overdose related deaths by 79% after permitting doctors to prescribe buprenorphine with opioid addicts. Similar results have been observed in the UK, US, and Netherlands.

It’s important to not hail medication as end all be all of opioid treatment, and instead acknowledge its ability to begin helping recovery instead of setting individuals up to fail. It is proven to help addicts recover faster, improve their ability to work or study during recovery, avoid committing crimes, and prevent overdoses.

opioid use outcomes or pharmacological treatment chart
Studies showed positive recovery outcomes for Buprenorphine treatment combined with behavioral intervention, specifically for prescription opioid addiction. Image courtesy of Recovery Research Institute

Drawbacks to Medication

No treatment is perfect, and MAT does have some risks. The drugs used can give people a high when taken at the wrong doses or administered differently, Typically this is a small percentage of patients though. Also the withdraw from these drugs can be similar to heroin, and occasionally individuals still use while taking the medication, though fortunately often much less.

sad addicted woman with pill bottles on counter

Key to Opioid Treatment

The key to success in opioid treatment is engaging those needing help at the level they are comfortable with. If they are not ready for complete abstinence, this treatment can make them more likely to begin the road to recovery. It will help ease withdrawals and control cravings and makes functioning through recovery much easier.

In the battle against the opioid epidemic, MAT is proven to reduce fatal overdoses and than traditional treatment methods and should be considered.

man taking prescription pill

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